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Children's care: family centred but child focused

25 May 2023
Volume 32 · Issue 10


Family-centred care is a widely used but loosely defined model of care often used in children's nursing. Although this allows for flexibility in its application, it also means that nurses can have very different ideas about its meaning. Recent decisions about the implementation of the COVID-19 vaccination programme for children under the age of 16 years in the UK and other countries have further confused this, as it has brought into question the relative position of children and their families in the decision-making process. Over time, the legislative and social positions of children have changed. Children are increasingly seen as being separate but related to their family, with an emphasis on their own human, legal, and ethical rights, including allowing children to choose the type of support they require for their care to reduce any undue stress. This article puts these into a current and contextual framework to better help nurses understand the historical as well as the contemporary reasons for the status of family-centred care today.

This article was prompted by the controversy surrounding the decision to recommend the vaccination of children and young people against COVID-19, and discussions about the process for gaining consent for this. These discussions refocused attention on the way that health care is delivered to these groups and, in particular, on who should consent and under what circumstances, and for whose benefit interventions are given. For children's nurses, this goes to the very essence of what nurses do and how they understand children's nursing. In addition, it reignited the discussion about the context of family-centred care, and how it will move forward in an age where children's rights as individuals are increasingly recognised. This article aims to discuss this in the context of current and previous legislation and guidance. It is important that nurses remember that at all times they have both a professional and a legal duty of care (Royal College of Nursing (RCN), 2023). Judgements about these require a broad knowledge of these areas and other influencing factors, which this article will summarise.

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